Traumatic experiences during childhood are strongly associated with the development of substance use disorders (SUD).1,2 With 50–90% of individuals in SUD treatment reporting experience of one or more traumatic events during their lifetime,3–5 it should not be surprising that the prevalence of PTSD is significantly greater in this population than in the general population.6 Among individuals in SUD treatment, co-occurring PTSD tends to be associated with greater impairment and worse treatment outcomes,6,7 although not all studies agree on the latter point.8,9 The evidence that trauma history predicts treatment outcomes independent of current PTSD diagnosis is even more mixed. Several studies have reported an association between relapse to substance use and childhood trauma3,10,11 or trauma during adulthood,8 but a number of other studies have failed to detect such a relationship.9,12
